OP0064 OBESITY IN PSORIATIC ARTHRITIS IS INCREASINGLY AFFECTING MEN AND APPEARS LESS DEPENDENT OF SOCIOECONOMIC STATUS THAN IN THE GENERAL POPULATION
Authors: M. Stirnimann, J. T. Maul, E. Vallejo-Yagüe, A. M. Burden, B. Moeller, M. J. Nissen, S. Kissling, O. Distler, C. Ospelt, A. Ciurea, R. Micheroli
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> Obesity in psoriatic arthritis (PsA) is associated with an elevated cardiovascular risk and higher disease activity. It represents a negative prognostic marker with a lower probability of remission on biologic therapy. Furthermore, obese patients with psoriasis have an increased risk of developing PsA. However, the prevalence of obesity in PsA compared with the general population and associated socioeconomic factors that would allow interventions targeted at these individuals are unknown. <h3>Objectives</h3> This study aimed to compare the prevalence of obesity in PsA patients and individuals from the general population at several time points and within those time points and find socioeconomic characteristics for obesity in PsA patients. <h3>Methods</h3> We compared the distribution of different body mass index (BMI) groups between patients with PsA from the Swiss Clinical Quality Management (SCQM) cohort and individuals from the general Swiss population using publicly available data from the Federal Statistical Office collected in 2007, 2012, and 2017. Patients were grouped into four BMI categories: underweight (BMI &lt;18.5), normal weight (BMI 18.5 to &lt;25), overweight (BMI 25 to &lt;30) and obese (BMI ≥30). A comparison of BMI categories between the general Swiss population and PsA patients was performed by sex and level of education using the Chi-Squared Goodness of Fit test. Patient characteristics were compared using Fisher's exact test for categorical variables. <h3>Results</h3> The PsA population recruited to the SCQM registry increased from 517 patients in 2007 (54.5% male, mean (SD) age 47.9 (22.7) years) to 1245 patients in 2017 (51.7% male, mean (SD) age 53.1 (23.9) years). Within this timeline the mean (SD) BMI of 26.6 (10.0) in 2007 raised to 27.5 (10.6) in 2017, representing a significant change (p&lt;0.001). Compared to the general Swiss population, the proportions of obese and overweight individuals were significantly higher in PsA patients at all collected time points (e.g., in 2017: 27.2% being obese and 36.6% being overweight in PsA patients compared to 11.3% being obese and 30.6% being overweight in the general Swiss population) (Figure 1A). In male PsA patients, the proportion of obesity increased, while female PsA patients had a slightly lower proportion of obese patients in 2017 than in 2012 (proportions of obese PsA patients in 2007, 2012 and 2017: 17.9%, 23.0%, and 27.3% in males compared to 22.4%, 28.8%, and 27.1% in females, respectively) (Figure 1B). Compared to the general Swiss population, the proportion of obese and overweight PsA patients was higher in both sexes at all three time points. Higher socioeconomic status represented by a higher level of education was associated with lower proportions of obesity and overweight in the general Swiss population at all three time points. However, patients with PsA lacked those differences in 2007. A decrease of obesity and overweight proportions in PsA patients exists only between secondary to tertiary education in 2012 and 2017. Between mandatory and secondary education, the proportions stay similar (Figure 1C shows the distribution of the BMI groups within education levels using data from 2017). In addition, PsA patients who worked in physically demanding occupations (e.g., transport, manufacturing or agriculture) had a comparable proportion of overweight and obesity as patients who worked in less physically demanding occupations (e.g., office workers, homemakers, teachers) (p=0.13). <h3>Conclusion</h3> Overweight and obesity are much more prevalent in patients with PsA than in the general population. Men have shown an increasing trend of obesity in recent years, and our data suggest that it is not only the socially disadvantaged who are at risk. There is an urgent need to address the expanding obesity epidemic in PsA with future public health incentives that should consider our findings. <h3>REFERENCES:</h3> NIL. <h3>Acknowledgements:</h3> NIL. <h3>Disclosure of Interests</h3> Marlene Stirnimann: None declared, Julia Tatjana Maul: None declared, Enriqueta Vallejo-Yagüe: None declared, Andrea Michelle Burden: None declared, Burkhard Moeller: None declared, Michael J. Nissen: None declared, Seraphina Kissling: None declared, Oliver Distler Consultant of: Abbvie, Caroline Ospelt: None declared, Adrian Ciurea: None declared, Raphael Micheroli: None declared.